As recently as February 23 we were corresponding with Kathryn Roe and the Andersons, excited about planning a trip to Ghana and and Southern Italy. But the coronavirus was on the radar screen already, and by February 29 Governor Inslee had declared a state of emergency, and the State Department recommended against non-essential travel to Italy (level 3 warning, their most severe). At that point the trip was off.

We had been planning that trip for April 10 to June 15, but on March 11 one of Seong's co-workers asked to take her mid March shifts, so suddenly we had an extra month of time off, starting immediately. Bellingham had no cases of COVID-19 yet, but we were pretty near the epicenter of Seattle, and Vancouver BC, just to the north of us, had reported cases as well. I picked Seong up at the Seattle airport on March 12 and we elected to pack up the car with ski gear and head for the border the following day, Friday the 13th. Auspicious!

Here, we put together a timeline (in retrospect, on March 22, by going through our emails and texts to friends and family):

Retrospective Covid Timeline:

In China: 4 odd pneumonia cases identified on 12/26; reported to their health authorities on the next day; market closure 1/1, virus genome is fully sequenced bu 1/7, test kits available by 1/13, 15 cities shut down by Jan 24. In retrospect, this was amazingly fast

1/15. The man who would become the first US case arrives from Wuhan, where, at that time, there were 41 people identified with the disease. The CDC issued a notice to US travelers from Wuhan who felt sick to seek care.

1/17. The US began checks of passengers from Wuhan at airports in NY, LA and SF.

1/30 The WHO issues a public health emergency declaration and the US State department issues a Level 4 (the highest) warning about travel to China; US citizens should not go. On the following day, all three US carriers (American, Delta, United) cancel all flight so mainland China and Trump restricts return of foreign nationals into the US, and institutes mandatory quarantine of US citizens returning.

2/1 On February 1, a Hong Kong hospital confirmed a patient tested positive of the Wuhan coronavirus. The said man was on board the Diamond Princess where he did not drop by the ship's medical center for symptom-checking.

According to the statement on Princess Cruises' official website, the ship was scheduled to return from a two-week itinerary on February 4 but the case of the patient previously on board the ship prompted the Japanese authorities to run tests on passengers, delaying the ship's Yokohama turnaround. The cruise ship was quarantined and the first 10 cases testing positive transported to Japanese health facilities.

2/24. Still planning southern Italy trip in discussions with the Andersons; emails to Kathryn show no hesitation

2/25. The CDC issues its first major warning that the outbreak could cause “severe disruption” to the lives of ordinary Americans, and urged families and communities to start making preparations. Federal health officials starkly warned that the new coronavirus will almost certainly spread in the United States, and that hospitals, businesses and schools should begin making preparations. “It’s not so much of a question of if this will happen anymore but rather more of a question of exactly when this will happen,” Dr. Nancy Messonnier, director of the National Center for Immunization and Respiratory Diseases, said in a news briefing. She said that cities and towns should plan for “social distancing measures,” like dividing school classes into smaller groups of students or closing schools altogether. Meetings and conferences may have to be canceled, she said. Businesses should arrange for employees to work from home.

The extent of the spread of the virus in the US is uncertain, as the CDC stopped the distribution of coronavirus testing kits after they were found to be flawed. Working testing kits are now available in only a handful of states, and it is not clear when new kits will be ready. Donald Trump tells journalists in India that coronavirus is “very well under control in our country” and “is going to go away”.

2/29. CDC level three alert, no nonessential travel to Italy; we tell the Andersons that we will “probably” stay in the US this spring

3/2. Four more die in Seattle for a total of six. The tone in our emails to the Andersons is still rather casual.

3/3 Breakfast with Mark Knittel at Whole Foods. No big deal. A chart comes out showing that the US is not testing at all yet.

3/4. The outbreak in Italy surpassed 3,000 infections and 100 deaths, and officials there ordered all schools closed. Cruise ship Grand Princess is held off the coast. I listen to a podcast by Emily Landon, ID prof and head of infection control at Univ of Chicago, and later send links to it to Seong, Mark Knittel, others. This is one of the first of the really alarming podcasts that I listen to from heads of epidemiology and ID, and coordinators of previous outbreaks such as Ebola etc.

3/5. In an email to Kathryn, we are keeping options open but “pretty strongly suspect that trip to Ghana is not in the cards”. Everyone is talking about canceling international travel now, including Mark Knittle and Joe. We had pretty much decided by this time though that international travel was not wise.

3/7. I go to a boating seminar; people are touching elbows and an announcement is made about hand washing; they have handwashing available but we are still in a big crowded room and there are snacks. I text this to Seong: Class is good. One of the speakers is a retired family physician and says coronavirus is in the community and is recommending here hand washing, no touching our faces, etc!

3/8. I text Seong that I am much more concerned about CV than most, and text to her "I think I’m more concerned about coronavirus than others are. I think about how interconnected everything is, and a disruption anywhere will have a lot of consequences. For instance, imagine a elementary school that decides to close down for a month. If there is a working single parent, he or she will probably have to stay home from work. Imagine if that’s a healthcare worker, police or fire. And I expect people will greatly reduce their travel, eating out, events of any kind where there are lots of people. So a lot of small businesses will have a lot of trouble. But more importantly- ICUs are usually near capacity all the time. Won’t they easily get overwhelmed, then those who need ventilation not get it?"

Later that day, the Italy death toll soars.

3/9. There is no hand sanitizer or isopropyl alcohol available, but the hardware store has some wipes plus denatured alcohol and acetone

Texted Neil with concern about the healthcare system and no wiggle room with ICUs, and a series of nine tweets from Italy where they healthcare system was breaking down.

Frances wondered if we were still coming to Arizona; we hadn’t really talked about it yet, but the next day we cancel the Phoenix trip. The NYT is making daily maps of where the hotspots are, and as of 3/9, Seattle is still the most active. But not for long.

3/10. First case is confirmed in Whatcom County. Trump is still describing it as "a lot like seasonal flu", and I text to Sheasby: “Do you understand the republican media strategy around coronavirus? It doesn’t make sense to me. The risk/reward equation for under v overplaying the risks is so asymmetric that I see no scenario in which their approach is sensible. Do you?” His response: "? “Media strategy” … ? … the media is a veritable joke and what I see and hear from Trump et al is simply a “prepare for the worse and hope for the best” strategy that they are simply sharing with the public - the “May seem media” will spin it as negatively as possible - almost all the Dems want open borders and prioritized impeachment when this problem was percolating and casted “you’re a racist” stones for limiting travel to/from China early on which appears to have been most prudent. Those were great strategies!! I suspect Trump et al’s first priority is dealing with this in the best ways possible and getting the word out is way down on the list. Meanwhile Schumer is largely about pushing social programs tangentially related to the real problem. And I’ve even seen in the MSM that it’s racist to tie this to “China” and it should be called the TrumpVirus - what do you think about those media strategies?"

3/12. I pick up Seong at the airport after her last set of shifts in Ketchikan rather than have her be in a shuttle bus with so many other people who had just been in Seattle or possibly traveling internationally.

David Greenspan texting me from Morocco, wondering if he sill get home; Lisa and the kids terrified; Moroccan health care total crapshoot. One way would be to fly from Marrachech to Dakar then home. But the flight to Dakar is $9800! Later that same day his travel planners get him on a direct flight from Casablanca to NYC. We discuss the difference between Italy, with more than 1000 deaths at that point, and South Korea, with 67.

3/13. We had decided to head to Canada tomorrow, Saturday, with all of ours ski equipment, when it occurred to us that the border could close. So we packed up and headed off today, advancing our airbnb reservation in 108 mile by one day.

3/16. Peacehealth recommends that their surgical department heads make a plan to cancel elective procedures; Trump press conference in which he changes tone dramatically and the “no big deal, it’s a lot like flu” narrative is over.

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